Adult Intertrochanteric Femoral Fracture In Clinical Research: Extramedullary Fixation And Intramedullary Fixation

Objective: to survey and analysis of jiangxi province is home to more than3–Ahospital adult intertrochanteric femoral fracture of the treatment between rotor andexplores the marrow of fixed and intramedullary fixed two internal fixation method totreat intertrochanteric femoral fractures between the differences and curative effect.Materials and methods: a retrospectie multi-center study, analysis in January2009to December2011in the province is home to more than216cases were3-A hospitalintertrochanteric femoral fractures between the clinical data. Divided into thetreatment group with fixed (149cases): dynamic hip screw (dynamic hip screw, DHS)and proximal femur anatomical steel plate; Intramedullary fixed the treatment group(n=67): Gamma nailing, proximal femoral nail system (proximal femoral nailsystem, PFN) and the proximal femoral nail antirotation nailing (proximal femoralnail antirotation, PFNA). Observe indicators include incision length, operation time,perioperative blood loss, intraoperative complications, intraoperative andpostoperative X line exposure times led flow, actually on time, and the fracturehealing time, postoperative clinical hip function score (Harris score) andpostoperative complications, and compare the results of each group.Results: all cases were all the1-3years; In the incision length, peri-operativebleeding and postoperative lead flow, the pulp group and intramedullary group bothquite, no statistical difference (p﹥0.05); In the healing time, functional score, twoquite, no statistical difference (p﹥0.05); In the operation time, X-ray exposuretimes, intraoperative complications, intramedullary group are higher than the marrowgroup, statistically significant (p﹤0.05); Will Ⅲ type, type Evans points Ⅳ typepatients complication compare alone, the complications of pulp group wassignificantly higher than the intramedullary group, statistically significant (p﹤0.05).Conclusion:(1) in the marrow treatment group outside subtrochanteric femoral fracturesbetween (Evans Ⅲ type, Ⅳ type) postoperative complications of follow-up, screw internal fixation about cutting, become loose, such as steel fracture incidence rate ofpostoperative complications were higher, medical workers should take intramedullaryfixation;(2) intramedullary fixed technology subtrochanteric femoral fractures betweentreatment in provincial development later, and medical workers as soon as possibleshould be closed reduction, put to nail technology, intraoperative closed reductionshould as far as possible, reduce the damage, promote the healing;(3) intramedullary fixed group blood vessels, nerve damage, cure source sexfracture in the operative complications in the group was higher than the pulp, this isnot consistent with international mainstream.(4) subtrochanteric femoral fractures between treatment choice can’t dependentirely on fracture type points, combine a patient’s general medical workers andproficiency in surgery.